Content

• Steps
• Advice

The rectal exam is a screening test for both men and women to detect abnormalities in the rectum, anus, and prostate (for men), such as cancer, infections and other lesions. . This test should be done periodically (annually) during a physical exam. Only medical professionals should have rectal exams as untrained persons can damage delicate rectal / anal tissues during the examination.

Steps

Part 1 of 2: Rectal Examination

1. 

   Explain this procedure to the patient and confirm their consent. If you are a medical professional who needs to examine a patient's rectum, the first step is to explain this test to them. Then ask them to sign the confirmation if they agree to do so.
   • You can explain as follows, “For this test I will put on gloves and insert my finger into my rectum to check for any abnormalities in it. You may experience a jolt and / or discomfort, but the test will only last a minute or two. ”

2. 

   
   
   Hand sanitizer and gloves. Before performing any procedure on a patient / other person, you must wash and sanitize your hands to avoid giving them bacteria, viruses or parasites. Using warm water and soap is enough to sanitize your hands, but you should use an alcohol-based antiseptic gel. Dry your hands completely and put on a pair of new medical gloves that do not contain nitrile or latex.
   • In the medical field, a finger rectal exam (DRE) is usually done by your family doctor, gynecologist, rectal specialist or nurse.
   • The rectum is a branch of medicine that deals with anal, rectal and colon problems.

3. 

   
   
   Reassure the patient and ask them to lie on their side. For both the doctor and the patient, rectal exam is a rather embarrassing or embarrassing process, so you need to act professionally and reassure them. After a general explanation of the procedure, ask them to undress below, lie on their side (usually lean to the left side), bend their knees up and place their hands near the chest - this is the fetal position. Cover them with a cape or blanket to keep them warm and secure. Put a protective mattress under their buttocks.
   • DRE can be performed upright. Women can have a rectal exam during a pelvic floor exam, so they'll lie on their backs with their legs raised. Men are usually examined upright, unless they are concerned the lying position may help them relax. Lying on your side is usually more relaxing, and your doctor can also have easier access to the anal canal.
   • To avoid embarrassment, DRE should be performed by a doctor of the same gender as the patient. Men examine men, women examine women, or request a nurse's presence during the visit.
   • To reduce anxiety and embarrassment, you can ask for a friend or relative to be present during the exam.
   • Adjust the patient's posture and cover them with blankets to keep them warm and private.

4. 

   
   
   Apply warm lubricant to your index finger. It is polite and to help prevent shock or discomfort, you need to warm up the lubricant slightly before applying it to your index finger. Even the gel at room temperature makes the patient cold and causes the anal canal to shrink, making it more difficult to examine with fingers. Your goal is to make sure the anal tissue is as relaxed as possible, so that it doesn't cause discomfort or pain when your finger is inserted.
   • Sometimes a rectal exam is done with anesthetic to numb the anal area and relieve discomfort. This is especially important if the examiner has large fingers and the patient has tight anal sphincter.
   • Gel warmers are inexpensive and can be found in medical equipment stores. Alternatively, you can warm the gel and lubricant in the microwave for 20-30 seconds.

5. 

   Gently insert your finger into the anal canal. After applying lubricant to your fingers and anus, separate the client's buttocks and slowly insert your index finger. It's best to ask the client to take a deep breath while inserting their fingers to help them relax and prevent the anal sphincter from contracting. To make it easier to insert your finger into your anus, slowly turn your hand in a back and forth motion.
   • Just before inserting your finger, make a quick assessment of any abnormalities in the anus, such as hemorrhoids (swollen blood vessels), warts, erythema or cracks.
   • After inserting a finger into the rectum, assess the firmness of the anus by asking the client to press to squeeze your finger.

6. 

   Touch for unusual places. Once your finger is inserted into the rectum, feel for abnormalities such as lumps, hard spots, soft spots, or cracks. Rotate your finger clockwise and vice versa to feel the entire rectal circumference. You can also tap the prostate gland through the rectal wall. Touch the front of the body to find the prostate, which has two lobes and a gap in the middle.
   • A healthy prostate will feel flat and painless to the touch.
   • If you experience pain when pressing on the prostate gland, it could be a sign of a benign tumor, infection, or cancer.
   • When pressing hands or examining the prostate gland from the anal canal, it often feels like you are urinating.

7. 

   Remove your finger and clean the area after examining. After the visit is complete, slowly remove your finger and examine the gloves for blood and / or mucus.Clean the lubricant around the anus, remove and throw away gloves, and then wash your hands. Have the client self-sanitize soft tissue towels in private and let them know they can re-dress.
   • To remove the dirty glove, use the index finger of the other hand (clean hand) under the cuff, then pull the glove towards the tip of your hand and remove.
   • The exam itself won't bleed, so if you see the blood on the glove it could be a sign of hemorrhoids or other problems.
   • After the procedure is done, ask the client how they are feeling, especially if they have been worried before. Remember that switching from lying down to standing makes some people feel dizzy, so remind the client to get up slowly and watch them for a few minutes.

Part 2 of 2: Understanding rectal exams

1. 

   Have an anal-rectal exam if you have blood in your stool. If you see blood in the toilet bowl while having a bowel movement or wiping your anus see your doctor. If your doctor suspects that you are bleeding from somewhere in the digestive tract (namely the large intestine or colon), they will order a colonoscopy. Some of the most common reasons for blood in the stool are: hemorrhoids, small cracks in the anus, and rupture of blood vessels due to pressing or wiping too hard.
   • More seriously, some other causes of bleeding are: anal-rectal cancer or some form of irritable bowel syndrome, such as ulcerative colitis or Crohn's disease.
   • If your doctor does not see any clear signs then your condition is normal, but an anal-rectal examination does not rule out all causes. You may need other tests, like a colonoscopy or an x-ray.
   • DRE is usually taken without taking any medicine as it is rarely painful. This visit only lasts a few minutes.

2. 

   See your doctor if you are a man and have difficulty urinating. Another common reason to examine the anus - rectum is to examine the prostate gland for abnormal lumps or pain to the touch. The prostate gland is about the size of a walnut, and secretes fluid when you ejaculate to protect and nourish sperm cells. The prostate gland is located near the bladder and in front of the rectum, so it can be checked easily with the DRE test. A swollen or inflamed prostate can cause pelvic pain and some problems with urination, such as dripping and difficulty urinating at first.
   • In men, DRE is done to check the size of the prostate gland, and look for unusual lumps or tenderness. A benign prostate tumor is very common (but not serious) in American men over the age of 50. However, melanoma is serious, and additional testing to detect it early increases the likelihood of successful treatment. Check it every year or more often if you suspect you have a problem.
   • If your doctor thinks your prostate is abnormal, he or she will likely order a blood test for prostate-specific antigen (PSA). High PSA levels are sometimes a sign of prostate cancer.
   • Another test used to predict a prostate problem is an ultrasound (trans rectal ultrasound) and is often done in conjunction with a prostate biopsy (tissue sampling).

3. 

   Request an anal - rectal examination during the periodic physical exam. You should visit the anus - rectum periodically instead of waiting for symptoms appear in the gastrointestinal tract. Most doctors recommend adding a DRE test to your yearly wellness visit, whether you are a woman or a man. Men should consider doing DRE when they get screened for prostate disease every year, especially if they are over 40 years old. Finger exam and stool blood test (stool sample) are recommended if you are over 40 years old. Women should have these tests done with an annual gynecological exam.
   • For men, DRE is performed in an upright position at the waist because this position makes it easier to reach the prostate gland.
   • For women, ovarian and uterine cancers can be found when the doctor does DRE with a vaginal exam.
   • In addition to rectal bleeding symptoms and urinary problems, other reasons for DRE are: change in bowel habits, pelvic and / or abdominal pain, discharge or bleeding from the urethra.

Advice

• There is no need to prepare for an anal-rectal examination and you should be able to function normally after your exam. Having a bowel movement in the past can make the exam more comfortable.
• DRE can be done to get stool samples for screening for rectal cancer.
• Exploring the anal canal with your finger can stimulate the feeling of bowel movements, so you should have a bowel movement before doing DRE.